Cognitive deficits, psychopathology, and psychosocial functioning in bipolar mood disorder.

The objective of this study was to study the relationship of poor functioning, cognition, and psychopathology in bipolar mood disorder. The authors assessed 36 patients with bipolar mood disorder (23 VA, 13 community) for the presence of psychopathology, cognitive deficits, and psychosocial impairment. The authors assessed psychopathology using screening and follow-up questions based on the schedule for affective disorder and schizophrenia, lifetime version (SADS-L), schedule for the assessment for negative symptoms (SANS), and schedule for the assessment of positive symptoms (SAPS), and psychosensory features using the "Profile of Psychomotor Symptoms." They tested cognitive functioning in the following domains: 1) general intelligence and language, 2) verbal and visual memory, and 3) visuospatial functioning. They also assessed psychosocial functioning using a structured scale to assess maladjustment and an impairment rating scale. Patients with bipolar disorder showed significant impairment compared to age equivalent normals in several cognitive domains. Anhedonia was related to memory deficits. Memory deficits were also associated with poor psychosocial functioning. This study demonstrates that nondemented, asymptomatic patients with bipolar disorder exhibit substantial cognitive deficits that are associated with poor functioning, and anhedonia and avolition best predict this outcome.